In the hospital setting, patients who are acutely unwell may have a pharmacist review their medications on a daily basis while they are unstable. This is because it’s likely their condition and medications are frequently changing.
Ideally, a person’s medications should be reviewed by a pharmacist every time there is a change in their state of health or medication regime. However, this is not always practical or feasible.
In Australia, currently there are restrictions on how often you are entitled to a medicine review (excluding in hospital) and this is purely for money saving reasons and to prevent people from playing the system. It also means the ones at highest risk of medicine misadventure are targeted.
Currently, you are entitled to a medicine review if your GP thinks you would benefit from one. You are then not entitled to another medicine review for 12 months (6 months if you are in a care facility) unless there is a good reason for another one. For example, if you were recently discharged from hospital or if there have been significant changes to your medications or health.
If a person’s condition changes, this may also affect how their medications work. For example, if an elderly patient becomes significantly dehydrated through a bad bout of gastro, this could potentially throw their kidneys out and a medication that would normally be cleared by the kidneys may build up to dangerous levels, becoming toxic or causing unwanted side effects. Or, if someone with diabetes becomes unwell and is not able to eat, then their blood-glucose-lowering medications would need to be reviewed and potentially held until they are eating again.
GPs are fabulous at prescribing and are very knowledgeable about drugs, however, their focus is on treating the condition and doing no harm. Pharmacists are the medication experts and there are a lot of other things to consider when starting, changing or stopping medications, such as possible interactions, side effects, withdrawal symptoms, or additional monitoring. Pharmacists must also keep up to date with all the new medication therapies available that GPs may not be familiar with yet.
Pharmacists are a second pair of eyes for GPs to help ensure medications are being used safely and effectively. In an ideal world, pharmacists would be there at every interface when medication changes take place to intervene at the most critical time – before problems arise.
Your GP will determine when and if your medications need to be reviewed again. If you have any concerns about your medications and feel you would benefit from another medicine review or think a medicine review would give you peace of mind, then by all means ask your doctor for the referral.